U.S. patent number 10,010,336 [Application Number 14/484,824] was granted by the patent office on 2018-07-03 for medical devices with detachable pivotable jaws.
This patent grant is currently assigned to Cook Medical Technologies, Inc.. The grantee listed for this patent is COOK MEDICAL TECHNOLOGIES LLC. Invention is credited to Michelle D. Martinez, Tyler Evans McLawhorn, Vihar C. Surti.
United States Patent |
10,010,336 |
Martinez , et al. |
July 3, 2018 |
Medical devices with detachable pivotable jaws
Abstract
Medical systems, devices and methods are provided for engaging
tissue, e.g. for clipping tissue, closing a perforation or
performing hemostasis. Generally, the medical system including a
housing, first and second jaws rotatable relative to the housing, a
driver, and an elongate drive wire. The elongate drive wire may be
disconnected from the driver, first and second jaws, and the
housing, which are left in vivo engaged with the tissue. The
medical device of the system may include a biasing strip engaged
with the jaws, and/or a gripping strip attached to at least one of
the jaws to improve the engagement of the tissue between the
jaws.
Inventors: |
Martinez; Michelle D.
(Winston-Salem, NC), Surti; Vihar C. (Winston-Salem, NC),
McLawhorn; Tyler Evans (Winston-Salem, NC) |
Applicant: |
Name |
City |
State |
Country |
Type |
COOK MEDICAL TECHNOLOGIES LLC |
Bloomington |
IN |
US |
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Assignee: |
Cook Medical Technologies, Inc.
(Bloomington, IN)
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Family
ID: |
52111512 |
Appl.
No.: |
14/484,824 |
Filed: |
September 12, 2014 |
Prior Publication Data
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Document
Identifier |
Publication Date |
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US 20140379018 A1 |
Dec 25, 2014 |
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Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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13270851 |
Oct 11, 2011 |
9339270 |
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12971873 |
Jul 8, 2014 |
8771293 |
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61391881 |
Oct 11, 2010 |
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61289297 |
Dec 22, 2009 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B
17/29 (20130101); A61B 17/10 (20130101); A61B
17/285 (20130101); A61B 17/08 (20130101); A61B
17/282 (20130101); A61B 17/122 (20130101); A61B
2017/2931 (20130101); A61B 2017/2932 (20130101); A61B
2017/2943 (20130101); A61B 2017/12004 (20130101); A61B
2017/2936 (20130101); A61B 2017/2902 (20130101); A61B
2017/00473 (20130101); A61B 17/1285 (20130101); A61B
2017/2944 (20130101) |
Current International
Class: |
A61B
17/28 (20060101); A61B 17/285 (20060101); A61B
17/29 (20060101); A61B 17/08 (20060101); A61B
17/10 (20060101); A61B 17/122 (20060101); A61B
17/128 (20060101); A61B 17/00 (20060101); A61B
17/12 (20060101) |
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Primary Examiner: David; Shaun L
Attorney, Agent or Firm: Brinks Gilson & Lione
Parent Case Text
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a Continuation-In-Part of U.S. patent
application Ser. No. 13/270,851 filed Oct. 11, 2011, which claims
the benefit of U.S. Provisional Patent Application Ser. No.
61/391,881 filed on Oct. 11, 2010, and is also a
Continuation-In-Part of U.S. patent application Ser. No. 12/971,873
filed on Dec. 17, 2010, now U.S. Pat. No. 8,771,293, which claims
the benefit of U.S. Provisional Patent Application Ser. No.
61/289,297 filed on Dec. 22, 2009. All of the foregoing
applications are hereby incorporated by reference.
Claims
The invention claimed is:
1. A medical device for engaging tissue, the medical device
comprising: a housing defining an internal passageway and a
longitudinal axis extending between proximal and distal ends of the
housing; a first jaw rotatable relative to the housing, the first
jaw having proximal and distal ends; a second jaw rotatable
relative to the housing, the second jaw having proximal and distal
ends, the first and second jaws including portions proximal to
their distal ends that are spaced apart to define a gripping space
therebetween; a driver engaged with the proximal ends of the first
and second jaws, longitudinal movement of the driver rotating the
first and second jaws relative to the housing; and a gripping strip
positioned between the first and second jaws, the gripping strip
fixedly attached to a distal portion of the first jaw, the gripping
strip projecting towards the second jaw and positioned to engage
tissue between the second jaw and the gripping strip, the gripping
strip projecting through the gripping space to define a space
between the first jaw and the gripping strip, wherein the gripping
strip has a concave shape with a concavity facing the first
jaw.
2. The medical device of claim 1, wherein, in a closed position of
the medical device, the distal ends of the first and second jaws
engage each other, and the gripping strip projects through the
gripping space to a location immediately adjacent the second
jaw.
3. The medical device of claim 2, wherein the gripping strip
engages the second jaw in the closed position when no tissue is
located between the first and second jaws.
4. The medical device of claim 1, wherein the gripping strip
includes a distal portion extending radially towards the second
jaw, and a proximal portion extending radially away from the second
jaw.
5. The medical device of claim 1, wherein the gripping strip
includes a proximal end that is not attached to the first jaw such
that the proximal end of the gripping strip is free floating for
movement relative to the first jaw.
6. The medical device of claim 1, wherein the gripping strip
includes at least one projection extending radially inwardly
towards the longitudinal axis, the at least one projection sized
and structured to engage the tissue between the first and second
jaws.
7. The medical device of claim 6, wherein the at least one
projection has a triangular shape terminating in a sharp distal end
for piercing tissue.
8. The medical device of claim 6, wherein the at least one
projection is formed by stamping the gripping strip.
9. The medical device of claim 1, further comprising a biasing
strip positioned between the first and second jaws, the biasing
strip operatively connected to at least one of the first and second
jaws to bias the jaws radially.
10. The medical device of claim 9, wherein the proximal end of the
gripping strip is positioned between the biasing strip and the
first jaw.
11. The medical device of claim 9, wherein the proximal end of the
gripping strip is positioned between the biasing strip and the
second jaw.
12. The medical device of claim 9, wherein the biasing strip is
fixed to a distal end of the driver and moves therewith.
13. The medical device of claim 1, further comprising a second
gripping strip positioned between the first and second jaws, the
second gripping strip attached to a distal portion of the second
jaw, the second gripping strip projecting towards the first jaw and
positioned to engage tissue between the first and second gripping
strips.
14. The medical device of claim 1, wherein the gripping strip is
separately formed from, and attached to, the first jaw.
15. The medical device of claim 1, wherein the gripping strip is
laterally positioned to be aligned with the longitudinal axis.
16. The medical device of claim 1, wherein the gripping strip, from
the distal end to the proximal end, extends towards and then away
from the second jaw.
17. The medical device of claim 1, wherein the first and second
jaws are non-detachably connected to the housing.
18. A medical device for engaging tissue, the medical device
comprising: a housing defining an internal passageway and a
longitudinal axis extending between proximal and distal ends of the
housing; a first jaw rotatable relative to the housing, the first
jaw having proximal and distal ends; a second jaw rotatable
relative to the housing, the second jaw having proximal and distal
ends; a driver engaged with the proximal ends of the first and
second jaws, longitudinal movement of the driver rotating the first
and second jaws relative to the housing; and a gripping strip
positioned between the first and second jaws, the gripping strip
attached to a distal portion of the first jaw, the gripping strip
projecting towards the second jaw and positioned to engage tissue
between the second jaw and the gripping strip, wherein the gripping
strip includes a distal end fixedly attached to the first jaw and a
proximal end that is not fixedly attached to the first jaw, wherein
the gripping strip, from the distal end to the proximal end,
extends towards and then away from the second jaw.
19. The medical device of claim 18, wherein the gripping strip is
separately formed from, and attached to, the first jaw.
20. The medical device of claim 18, wherein the gripping strip
engages the second jaw in the closed position when no tissue is
located between the first and second jaws.
21. The medical device of claim 18, wherein the proximal end of the
gripping strip is free floating for movement relative to the first
jaw.
22. The medical device of claim 18, wherein the gripping strip has
a concave shape with a concavity facing the first jaw.
23. The medical device of claim 18, further comprising a biasing
strip positioned between the first and second jaws, the biasing
strip operatively connected to at least one of the first and second
jaws to bias the jaws radially.
24. The medical device of claim 23, wherein the proximal end of the
gripping strip is positioned between the biasing strip and one of
the first and second jaws.
25. The medical device of claim 18, wherein, in a closed position
of the medical device, the distal ends of the first and second jaws
engage each other, and the gripping strip projects through the
gripping space to a location immediately adjacent the second
jaw.
26. The medical device of claim 25, wherein the gripping strip
engages the second jaw in the closed position when no tissue is
located between the first and second jaws.
Description
BACKGROUND
Conventionally, a clip may be introduced into a body cavity through
an endoscope to grasp living tissue of a body cavity for
hemostasis, marking, and/or ligating. Such clips are often known as
surgical clips, endoscopic clips, hemostasis clips and vascular
clips. In addition, clips are now being used in a number of
applications related to gastrointestinal bleeding such as peptic
ulcers, Mallory-Weiss tears, Dieulafoy's lesions, angiomas,
post-papillotomy bleeding, and small varices with active bleeding.
Clips have also been attempted for use in closing perforations in
the stomach
Gastrointestinal bleeding is a somewhat common and serious
condition that is often fatal if left untreated. This problem has
prompted the development of a number of endoscopic therapeutic
approaches to achieve hemostasis such as the injection of
sclerosing agents and contact thermo-coagulation techniques.
Although such approaches are often effective, bleeding continues
for many patients and corrective surgery therefore becomes
necessary. Because surgery is an invasive technique that is
associated with a high morbidity rate and many other undesirable
side effects, there exists a need for highly effective, less
invasive procedures.
Mechanical hemostatic devices such as clips have been used in
various parts of the body, including gastrointestinal applications.
One of the problems associated with conventional hemostatic devices
and clips, however, is that many devices are not strong enough to
cause permanent hemostasis. Further, clips have also been attempted
for use in closing perforations in the stomach or gastrointestinal
structures, but unfortunately traditional clips suffer from
difficult placement and the capability to grasp a limited amount of
tissue, potentially resulting in incomplete closure.
SUMMARY
The invention may include any of the following aspects in various
combinations and may also include any other aspect described below
in the written description or in the attached drawings.
In a first aspect, a medical device is provided for engaging
tissue, the medical device including a housing, first and second
jaws, a driver, a biasing strip, and a drive wire. The housing
defines an internal passageway and a longitudinal axis extending
between proximal and distal ends of the housing. The first and
second jaws are rotatable relative to the housing, and have
proximal and distal ends. The driver is engaged with the proximal
ends of the first and second jaws, whereby longitudinal movement of
the driver rotates the first and second jaws relative to the
housing. The biasing strip is operatively connected to at least one
of the first and second jaws to bias the jaws radially. The biasing
strip includes at least one projection extending radially inwardly
towards the longitudinal axis, the at least one projection sized
and structured to engage the tissue between the first and second
jaws. The elongated drive wire is selectively connected to the
driver for longitudinal movement therewith.
According to more detailed aspects, the biasing strip biases the
first and second jaws radially outwardly, and preferably is
directly attached to the driver and directly engages each of the
first and second jaws. The at least one projection preferably has a
triangular shape terminating in a sharp distal end for piercing
tissue, and is formed by stamping the biasing strip. The biasing
strip may include a first portion adjacent the first jaw, and a
second portion adjacent the second jaw, wherein the at least one
projection includes a first projection on the first portion of the
biasing strip and a second projection on the second portion of the
biasing strip. The biasing strip can be directly attached to the
driver at a location between the first and second portions. The
first and second jaws are preferably non-detachably connected to
the housing. A first end of the biasing strip may engage the first
jaw while a second end of the biasing strip may engage the second
jaw. A middle portion of the biasing strip is preferably fixed to a
distal end of the driver and moves therewith.
In a second aspect a medical device is provided for engaging
tissue, the medical device including a housing, first and second
jaws, a driver, and a gripping strip. The housing defines an
internal passageway and a longitudinal axis extending between
proximal and distal ends of the housing. The first and second jaws
are rotatable relative to the housing, and have proximal and distal
ends. The driver is engaged with the proximal ends of the first and
second jaws, whereby longitudinal movement of the driver rotates
the first and second jaws relative to the housing. The gripping
strip is positioned between the first and second jaws and attached
to a distal portion of the first jaw. The gripping strip projects
towards the second jaw and is positioned to engage tissue between
the second jaw and the gripping strip.
According to more detailed aspects, in a closed position of the
medical device, the first and second jaws each include distal ends
that engage each other, and also include portions proximal to their
distal ends that are spaced apart to define a gripping space
therebetween. Preferably, the gripping strip projects through the
gripping space to a location immediately adjacent the second jaw.
The gripping strip may engage the second jaw in the closed position
when no tissue is located between the first and second jaws. The
gripping strip preferably includes a distal portion extending
laterally towards the second jaw, and a proximal portion extending
radially away from the second jaw. A proximal end of the gripping
strip may be free floating. The gripping strip may also include at
least one projection extending radially inwardly towards the
longitudinal axis, the at least one projection sized and structured
to engage the tissue between the first and second jaws
According to further detailed aspects, the medical device may
further include a biasing strip positioned between the first and
second jaws, the biasing strip operatively connected to at least
one of the first and second jaws to bias the jaws radially. The
proximal end of the gripping strip may be positioned between the
biasing strip and the first jaw, or may be positioned between the
biasing strip and the second jaw. A second gripping strip may also
positioned between the first and second jaws, the second gripping
strip attached to a distal portion of the second jaw, the second
gripping strip projecting towards the first jaw and positioned to
engage tissue between the first and second gripping strips.
BRIEF DESCRIPTION OF THE DRAWINGS
The accompanying drawings incorporated in and forming a part of the
specification illustrate several aspects of the present invention,
and together with the description serve to explain the principles
of the invention. In the drawings:
FIG. 1 is a top view of a medical system having a medical device
for engaging tissue, constructed in accordance with the teachings
of the present invention;
FIG. 2 is a top view similar to FIG. 1, but showing the outer
structures in dotted lines and the interior sections in solid lines
and partial cross section;
FIG. 3 is a side view of the medical system and device depicted in
FIG. 1;
FIG. 4 is a side view similar to FIG. 3, but showing the outer
structures in dotted lines and the interior structures in solid
lines and partial cross section
FIG. 5 is a side view of a medical device that is part of the
medical system depicted in FIGS. 1-4;
FIG. 6 is a front view of a housing forming a portion of the
medical system and device depicted in FIGS. 1-5;
FIG. 7 is a perspective view of the housing depicted in FIG. 6;
FIGS. 8-12 are side views showing operation of the medical system
and device depicted in FIGS. 1-5;
FIGS. 13 and 14 are top views, partially in cross-section,
depicting operation of the medical system and device depicted in
FIGS. 1-4;
FIGS. 15 and 16 are cross-sectional views showing operation of the
medical system and device depicted in FIGS. 1-4.
FIGS. 17 and 18 are a perspective view of an alternate embodiment
of a grasping jaw forming a portion of the medical system and
device of FIG. 1;
FIG. 19 is a plan view of an alternate embodiment of a driver
forming a portion of the medical system and device of FIG. 1;
FIG. 20 is a perspective view of the driver of FIG. 19 shown
attached to a drive wire;
FIG. 21 is a side view of FIG. 20;
FIG. 22a is a plan view of an alternate embodiment of the medical
device of FIG. 1, and FIG. 22b is a plan view of the driver of FIG.
19 shown attached to a strip and forming a portion of the medical
device of FIG. 22a;
FIG. 23 is a plan view of another alternate embodiment of the
medical device depicted in FIG. 1;
FIGS. 24 and 25 are a perspective views showing operation of the
medical device depicted in FIG. 23;
FIGS. 26 and 27 are perspective and end views, respectively, of
another embodiment of a driver forming a portion of the medical
system and device depicted in FIG. 1;
FIG. 28 is a perspective view of the driver of FIGS. 25-26 shown
attached to the jaws;
FIGS. 29 and 30 are plan views showing operation of the driver and
jaws depicted in FIG. 28;
FIGS. 31 and 32 are cross-sectional views of another embodiment of
the medical system and device depicted in FIG. 1;
FIG. 33 is a perspective view of the medical system and device
depicted in FIGS. 31 and 32;
FIG. 34 is a plan view of another alternate embodiment of the
medical device depicted in FIG. 1;
FIGS. 35 and 36 are side views showing operation of the medical
device of FIG. 34;
FIGS. 37 to 39 are side views showing operation of another
alternate embodiment of the medical device depicted in FIG. 1;
FIG. 40 is a side view of another alternate embodiment of the
medical device depicted in FIG. 1;
FIGS. 41 and 42 are side views showing operation of another
alternate embodiment of the medical device depicted in FIG. 1;
FIG. 43 is a side view of another alternate embodiment of the
medical device depicted in FIG. 1; and
FIG. 44 is a side view of another alternate embodiment of the
medical device depicted in FIG.
DETAILED DESCRIPTION
The terms "proximal" and "distal" as used herein are intended to
have a reference point relative to the user. Specifically,
throughout the specification, the terms "distal" and "distally"
shall denote a position, direction, or orientation that is
generally away from the user, and the terms "proximal" and
"proximally" shall denote a position, direction, or orientation
that is generally towards the user.
An exemplary medical system 20 having a medical device 40 for
engaging tissue T (FIG. 11) is shown in FIGS. 1 through 4. The
medical system 20 and device 40 are generally sized and structured
for operation through the working channel of an endoscope (not
shown) or other scope, although the system 20 and device 40 may
also be used alone or in conjunction with other elongate devices
such as catheters, fiber-optic visualization systems, needles and
the like. Generally, the medical system 20 includes a drive wire 22
slidably housed within the distal end 23 of an elongated catheter
24 for selective connection to, and operation of, the medical
device 40. As will be described in further detail herein, the
medical device 40 generally includes a housing 42 having a first
jaw 44 and a second jaw 46 pivotally connected thereto for engaging
the tissue T. Generally, the jaws 44, 46 have been shown as forming
grasping forceps, although the jaws are intended to be used to clip
tissue, e.g. to close an opening or for hemostasis. Accordingly, it
will be recognized that the shape and structure of the jaws may
take many forms and serve many purposes and functions, all in
accordance with the teachings of the present invention.
In the medical system 20, the drive wire 22 slidably extends
through the catheter 24. Although the term "wire" is used to refer
to the drive wire 22, it will be recognized that any elongate
control member capable of transmitting longitudinal force over a
distance (such as is required in typical endoscopic, laparoscopic
and similar procedures) may be used, and this includes plastic rods
or tubes, single filament or multi-filament wires, metal rods and
the like. The drive wire 22 should also be capable of properly
transmitting a rotational/torsional force from the proximal end to
the distal end to rotate the medical device 40 and jaws 44, 46, and
thus it is currently preferred that the drive wire 22 is formed
from nitinol (e.g. a nitinol wire) or other superelastic alloy. A
connection block 26 is slidably fitted within the distal end 23 of
the catheter 24 and defines a bore 28 therethrough which slidably
receives the drive wire 22. The exterior of the connection block 26
includes a recessed portion 27, and two pins 30 (e.g., formed from
stainless steel wire) are connected to the catheter 24 and
positioned within the recessed portion 27 to limit the longitudinal
movement of the connection block 26.
A distal end of the drive wire 22 defines a distal head 32 that is
sized larger than the drive wire 22, and likewise larger than the
bore 28 in the connection block 26. As will be described later
herein, the distal head 32 is used to slide the connection block 26
within the catheter 24 to disconnect the medical device 40 from the
medical system 20. As also seen in FIGS. 1-4, the housing 42 of the
medical device 40 is a tubular member defining an interior space
43. A proximal end of the housing 42 frictionally receives a distal
end of the connection block 26 within the interior space 43 for
selective connection therewith.
The internal passageway 43 of the housing 42 also receives the
first and second jaws 44, 46 and a driver 48 which is used to
interconnect the drive wire 22 to the jaws 44, 46. As best seen in
FIGS. 1, 2 and 5, the driver 48 has a proximal portion which
defines a socket 50 sized to receive enlarged distal head 32 of the
drive wire 22. At the proximal entrance of the socket 50, two
deflectable locking tabs 52 are formed which rotate relative to the
remainder of the driver 48 to increase or decrease the size of the
socket 50. The locking tabs 52 may be separately formed and
pivotally attached to the driver 48, or may be integrally formed
with the driver 48 and formed of a resilient material which flexes
to permit rotation of the locking tabs 52 radially inwardly and
radially outwardly. A distal portion of the driver 48 defines a
rack 54 for engaging and operating the jaws 44, 46. In the depicted
embodiment, the rack 54 includes a central spine 56 having teeth 58
projecting away from the central spine 56 and on opposite sides of
the spine 56. One set of teeth 58 on one side of the spine 56
generally operate the first jaw 44 while the other set of teeth 58
on the other side of the spine 56 operate the second jaw 46. It
will be recognized that the rack 54 may include a single set of
teeth or other geared structures that interface with the jaws 44,
46.
As best seen in FIG. 5, the first and second jaws 44, 46 include
distal ends 60, 62 that are structured to grasp and engage tissue,
generally they have a talon shape as disclosed in 61/141,934 filed
Dec. 31, 2008, the disclosure of which is incorporated herein by
reference in its entirety. The proximal ends 64, 66 of the first
and second jaws 44, 46 each include a pinion gear 68, 70 having a
series of teeth. The teeth of the pinion 68, 70 mesh with the teeth
of the rack 54 of the driver 48 such that longitudinal translation
of the driver 48 induces rotation in the first and second jaws 44,
46 relative to one another. Generally, distal translation of the
driver 48 causes the first and second jaws 44, 46 to rotate
outwardly away from each other, while proximal retraction of the
driver 48 causes the first and second jaws 44, 46 to rotate
inwardly toward one another. Pins 80 are fitted through each the
proximal ends of the jaws 44, 46, to pivotally connect the jaws to
the housing 42. Other structures for forming a pivotal connection
may be used, and preferably the pivotal connection is centrally
arranged relative to the pinions 68, 70.
In addition to the jaws 44, 46 being pivotally attached to the
housing 42, the first and second jaws 44, 46 are also slidably
attached to the housing 42. As best seen in FIGS. 6 and 7 (and in
conjunction with FIGS. 1-4) the housing 42 defines a first guide
surface 82 for the first jaw 44, and a second guide surface 84 for
the second jaw 46. As seen in FIG. 3, the first and second guide
surfaces 82, 84 are formed by elongated slots 82a, 82b, 84a, 84b
formed in opposing sides of the housing 42 which leaves a thickness
of the housing 42 exposed to serve as the guide surface. The slots
82a, 82b are aligned to receive the connecting pin 80 of the first
jaw 44, and likewise the slots 84a, 84b are aligned to receive the
connecting pin 80 of the second jaw 46. The ends of the slots, for
example distal ends 92, 94 shown in FIG. 7, serve to restrict the
longitudinal movement of the jaws 44, 46 relative to the housing
42. The proximal ends 64, 66 of the jaws 44, 46 include apertures
72, 74 which receive the pins 80 (FIGS. 1, 2 and 3) that are used
to slidably and pivotally connect the first and second jaws 44, 46
to the housing 42.
It can also be seen in FIGS. 6 and 7 that the housing 42 defines a
third guide surface 86 which guides the longitudinal movement of
the driver 48 within the housing 42. The guide surface 86 in the
depicted embodiment includes a left guide surface 86a and a right
guide surface 86b formed as C-shaped channels. As shown in FIG. 7,
the third guide surface 86 transitions from a smaller proximal
width to a larger distal width to define a shoulder 88 at the
transition, which will be further described hereinbelow with
reference to FIGS. 13 and 14.
As also shown in FIG. 6, the internal passageway 43 of the housing
42 extends through the distal end of the housing, and through which
the first and second jaws 44, 46 can extend. Additionally, as shown
in FIGS. 1 and 2, the housing 42 defines opposing slots 45 which
are sized to permit the first and second jaws 44, 46 to pass
therethrough when they rotate radially outwardly. Accordingly, it
is also clear from FIGS. 1 and 2 that the housing 42 serves to
block rotation of the first and second jaws 44, 46 when they are
entirely or partially contained within the internal passageway 43
of the housing 42. Suitable plastics for forming the housing
include, but are not limited to, polytetrafluorethylene (PTFE),
expanded polytetrafluorethylene (EPTFE), polyethylene ether keytone
(PEEK), polyvinylchloride (PVC), polycarbonate (PC), polyamide,
polyimide, polyurethane, polyethylene (high, medium or low
density), and suitable metals include stainless steel, nitinol and
similar medical grade metals and alloys.
Operation of the medical device 40 will now be described with
reference to FIGS. 8-12. As shown in FIG. 8, the first and second
jaws 44, 46 are shown in a retracted position where they are
substantially contained within the housing 42. Depending on the
application, the distal ends 60, 62 of the jaws 44, 46 may slightly
project from the distal end of the housing 42 in their retracted
positions, or they may be entirely positioned within the housing
42. When the drive wire 22 is translated distally (to the right on
the page in FIG. 8) the distal head 32 engages the driver 48, the
driver 48 and jaws 44, 46 slide distally through the housing 42.
The driver 48 and jaws 44, 46 slide longitudinally before they
rotate (even though the rack 54 of the driver 48 is meshed with the
pinions 68, 70 at the proximal ends 64, 60 of the jaws 44, 46)
since the resistance to longitudinal movement is less than the
force required to rotate the jaws 44, 46 (alternatively, the
housing 42 can block rotation of the jaws 44, 46 when they are
within the housing 42). As previously mentioned, this longitudinal
movement is guided by the first and second guide surfaces 82, 84
which receive the pins 80 that slidably and pivotally connect the
jaws 44, 46 to the housing 42.
As shown in FIG. 9, the first and second jaws 44, 46 have an
extended position where the jaws substantially project from a
distal end of the housing 42, and their proximal ends 64, 66 are
positioned adjacent the distal end of the housing 42. Accordingly,
it will be seen that further distal advancement of drive wire 22,
and hence the driver 48, causes the pinion 68 to rotate over the
teeth 58 of the rack 54. As best seen in FIG. 10, the first and
second jaws 44, 46 rotate radially outwardly from each other into a
tissue receiving position. Notably, due to the presence of slots 45
at the distal end of the housing 42, the jaws 44, 46 are permitted
to rotate a full 90.degree., thus forming at least a 180.degree.
between them. It will be recognized that through the sizing of the
slots 45 and the construction of the rack 54 and pinions 68, 70,
the first and second jaws 44, 46 may rotate even further away from
each other.
In the tissue receiving configuration shown in FIG. 10, the medical
device 40 and its jaws 44, 46 may be positioned adjacent tissue T.
As shown in FIG. 11, the tissue T may be placed between the first
and second jaws 44, 46 and the jaws 44, 46 rotated back towards
their position shown in FIG. 9. The tissue T has been shown as a
single layer, although multiple layers may be clipped between the
jaws 44, 46. Generally, proximal retraction of the drive wire 22
and the driver 48 again causes rotation of the first and second
jaws 44, 46 to grasp the tissue T therebetween. As shown in FIG.
12, further proximal retraction of the drive wire 22 and driver 48
will cause the jaws 44, 46 to move longitudinally in a proximal
direction (to the left on the page in FIG. 12).
In order for the medical device 40 to serve as a clip and maintain
its grasp on the tissue T, or to maintain the clipping of two
layers of tissue against each other, the jaws 44, 46 may be locked
in position and the drive wire 22 of the medical system 20
disconnected from the medical device 40. As shown in FIG. 13, the
third guide surface 86 (which guides the driver 48) includes a
proximal portion 86p and a distal portion 86d. The proximal portion
86p of the third guide surface 86 has a width (measured up and down
on the page in FIG. 13) that is greater than a width of the distal
portion 86d of the third guide 86. As previously discussed, the
third guide surface 86 is formed by opposing surfaces or C-shaped
channels 86a, 86b of the housing 42. The transition between the
proximal portion 86p and distal portion 86d defines a shoulder 88,
and namely two shoulders 88a, 88b on opposing sides of the housing
42. The shoulders 88a, 88b are sized and positioned to engage the
locking tabs 52 located on the driver 48.
As shown in FIG. 13, when the driver 48 is located within the
distal portion 86d of the third guide surface 86, the locking tabs
52 are forced radially inwardly into firm frictional engagement
with the drive wire 22. Stated another way, the socket 50 formed by
the driver 48 to receive the distal head 32 has an entrance which
is narrowed by the inward deflection of the locking tabs 52.
Preferably, the locking tabs 52 plastically deform rather than
elastically deform, and the tabs 52 may be bent inwardly around the
distal head 32 during initial assembly of the device, and thus
sized for the distal portion 86d of the third guide surface 86. In
this state depicted in FIG. 13, the drive wire 22 is firmly engaged
with the driver 48 and hence the first and second jaws 44, 46.
When the drive wire 22 and driver 48 are retracted proximally, for
example upon grasping tissue as shown in FIG. 12, the proximal end
of the driver 48 is received within the proximal portion 86p of the
third guide surface 86 which has a larger width that permits
radially outward movement of the locking tabs 52. Accordingly, in
the state depicted in FIG. 14, the locking tabs 52 may be loosely
and detachably connected to the distal head 32 of the drive wire
22. That is, the proximal retraction of the jaws 44, 46 will be
limited by either the tissue T engaging the distal end of the
housing 42, or the pins 80 will abut the proximal ends of the slots
82a, 82b, 84a, 84b defining a first and second guide surfaces 82,
84. As such, when proximal movement of the jaws 44, 46 and the
driver 48 are thus limited, further proximal movement of the drive
wire 22 and its distal head 32 may be used to withdraw the distal
head 32 from the socket 50 of the driver 48. This operation may
also be used to further deflect the locking tabs 52 radially
outwardly. An appropriate amount of distally directed force on the
drive wire 22 causes the distal head 32 to move proximally through
the locking tabs 52 and plastically deform them radially outwardly.
In the event the natural elasticity of the tissue T tends to pull
the jaws 44, 46 out from the housing towards their extended
position, the locking tabs 52, 54 will abut the shoulders 88a, 88b
of the third guide surface of the housing 42 to prevent further
distal movement of the jaws 44, 46.
Turning now to FIGS. 15 and 16, upon still further proximal
retraction of the drive wire 22 and distal head 32, the enlarged
distal head 32 will abut the connection block 26 which is slidably
fitted within the distal end 23 of the catheter 24. Sufficient
proximal force on the drive wire 22 will overcome the frictional
fit between the connection block 26 and the proximal end of the
housing 42, thus moving the connection block 26 proximally (to the
right on the page of FIGS. 15 and 16) to retract the connection
block 26 within the tubular connector 24, as shown in FIG. 16. The
catheter 24 can be used to provide a counterforce on the housing 42
while proximally retracting the drive wire 22 and connection block
26. Accordingly, the drive wire 22, catheter 24 and connection
block 26 may be fully disconnected from the medical device 40,
thereby leaving the first and second jaws 44, 46 and the housing 42
in a state having the tissue T clipped between the jaws 44, 46 and
retained in vivo. The connection block 26 is retained at the distal
end 24 of the catheter 24 via the pins 30, which are positioned
within the recessed area 27 to engage the proximal and distal ends
of the connection block 26 and limit its longitudinal movement.
The elongated catheter 24 (or other elongate tubular member such as
a sheath, tube, scope or the like), which slidably encases the
drive wire 22, extends proximally therealong to a proximal end of
the system 20, and has a length suitable for placing the device 40
at any desired location within the body, while the proximal ends of
drive wire 22 and catheter 24 are positioned outside of the body
for use by the medical professional. Control handles (not shown)
for controlling relative translation of the drive wire 22 and
catheter 24 are well known in the art, and may be employed at the
proximal end of the system 20.
Another embodiment and method of forming the grasping jaws 44, 46
are shown in FIGS. 17-18. The jaws of the prior embodiment were
generally machined, however the jaws 44, 46 may also be formed by
stamping. A flat piece of metal preferably of medical grade
stainless steel, is stamped into the shape 144 shown in FIG. 17.
The shape includes a slightly narrow distal end 160 which then can
be bent into the shape shown in FIG. 18 for grasping and engaging
tissue. The distal end 160 may also be stamped to include a
serrated edge, or other shapes or edge features depending upon the
application. The proximal end 164 generally includes two arms 166
which lead to gears 168. As shown in FIG. 18, the gears 168 are
grasped and then rotated about 90 degrees such that the gears 168
extend in a plane that is perpendicular to the plane of the sheet
144. The gears 168 also include a through-hole 172 for receiving a
guiding pin. It will also be recognized that the jaws 44, 46 in
this embodiment may also be formed of a single arm 166 and single
gear 168.
Another embodiment of a driver 148 and drive wire 122 are shown in
FIGS. 19-22. The driver 148 generally includes a socket 150 formed
by two locking tabs 152. In this embodiment, a proximal portion of
the locking tabs define slanted shoulders 154 which slope laterally
outwardly for engagement with the third guide surface 86 in the
housing 42 as previously discussed. The locking tabs 152 also
include inner projections 153 which project laterally inwardly and
separate the socket 150 into a distal portion 150d and a proximal
portion 150p. The driver 148 again includes a central spine 156 and
opposing teeth 158. In this embodiment, the distal end 166 of the
driver 148 includes a pocket 168 defined by two inwardly projecting
flanges 170, as will be discussed further herein. The two flanges
170 extend along a distal side of the pocket 168, and leave a gap
therebetween for access to the pocket 168.
As seen in FIGS. 20 and 21, this embodiment of the drive wire 122
includes a distal head 132 which is formed by bending the distal
end of the drive wire 122 into a semi-circular shape as shown,
preferably spanning an arc of 180 degrees to 360 degrees.
Accordingly, it can be seen that the distal head 132 defines an
opening 133 that is sized to receive the inner projections 153 of
the locking tabs 152. As shown, the distal portion 150d of the
socket 150 receives the distal-most part of the curved distal head
132, while the proximal portion of the distal head 132 projects
through the proximal portion 150p of the socket 150 and proximally
away therefrom. As noted above, the locking tabs 152 here are
structured to be plastically deformed, and thus after formation and
connection to the drive wire 122 as shown in FIG. 19, the tabs 152
are bent radially inwardly to secure the projections 153 within the
opening 133 of the socket 132. In this state, the exterior
shoulders 154 of the locking tabs 152 are sized to fit within the
third guide surface 86, and more particularly the distal portion
86d of the third guide surface 86 without further deformation.
As shown in FIGS. 22a and 22b, another embodiment of the medical
device 140 may include the housing 142, grasping arms 144, 146 just
as in the prior embodiment, but in this embodiment include the
alternate driver 148 and an additional biasing element, namely a
biasing strip 190. As best seen in FIG. 22b, the distal end 166 of
the driver 148 receives the biasing strip 190 within the pocket
168. The flanges 170 are bent inwardly and proximally as shown to
firmly engage the metal strip 190 and fix it to the driver 148. The
biasing strip 190 is preferably a thin strip formed from a sheet of
resilient material, and more preferably a metal strip, e.g. formed
of stainless steel, nitinol or other super elastic alloy that is
biocompatible. Accordingly, it will be recognized that as the
driver 148 is moved proximally to cause the jaws 144, 146 to close,
the biasing strip 190 will be forced into a V-shape or U-shape, as
shown by the dotted lines in FIG. 22a. That is, the biasing strip
190 has a straight shape in its natural, unbiased, configuration,
and when bent into the V-shape it exerts a radially outward force
on the jaws 144, 146. This biasing force provides the jaws 144, 146
with smooth rotation and transition between the open and closed
positions. It will also be recognized that the biasing strip 190
could also have its original, unbiased position formed as a V-shape
or a U-shape, and be affixed to the jaws 144, 146 such that it
exerts a radially inward biasing force. The free ends 192 of the
metal strip 190 simply press against the jaws 44, 46, but are not
fixed or rigidly attached thereto.
Turning to FIG. 23, another embodiment of the medical device 240 is
shown, again including a housing 242 and opposing jaws 244, 246
that are slidably attached thereto. The housing 242 again includes
first and second guides 282, 284 for guiding movement of the jaws
244, 246. In this embodiment however, each jaw 244, 246 includes a
biasing strip 290a, 290b, respectively. The distal ends 291 of the
strips 290a, 290b are fixedly attached to the exterior of the jaws
244, 246, preferably at their distal ends, and preferably by way of
an adhesive, soldering, welding, or other known bonding techniques.
As best seen in FIGS. 24 and 25, the housing 240 includes two
exterior channels 294 on opposite sides of the housing 240 (one
being shown in FIGS. 24 and 25) which are sized to receive the
resilient strips 290a, 290b such that they are flush with the
exterior surface of the housing in the closed/retracted
configuration. The proximal ends 293 of the strips 290a, 290b
include a T-shaped formed by a base 295 and cross bar 296. The base
295 extends through a smaller slot 296 formed through the housing
240. The slots 296 are coextensive with the channels 294. The cross
bar 296 rides along the interior of the housing 240 and maintains
the slidable connection between the strips 290 and the housing 240.
Accordingly, it can be seen that the proximal ends 293 of the
strips 290a, 290b are slidably and pivotably attached to the
housing 240 via the channel 294 and its slot 296, allowing the
strips 290a, 290b to travel with the grasping jaws 44, 46 as shown
between their open and closed positions as shown in FIGS. 24 an
25.
Turning now to FIGS. 26-30, another embodiment of a driver 348 is
shown. As best seen in FIGS. 26 and 27, the driver 348 again
includes a socket 350 formed by two locking tabs 352 which have
inner projections 353 and outer shoulders 354, and which divide the
socket 350 into a distal portion 353 and a proximal portion 350p.
Unlike the prior embodiments of the driver, in this embodiment the
distal portion defines a geared rack that has a Z-shape. Generally,
a central plate 356 replaces the central spine 56, 156 of the prior
embodiments, and the plate 356 extends in a plane that is parallel
to the longitudinal plane of the housing 342 (FIG. 29). The plane
of the central plate 356 is also perpendicular to a plane of the
proximal half of the driver 348 (i.e. that which includes the
socket 350 and tabs 352). A first set of teeth 358a project
laterally away from the central plate 356 in a first direction,
while a second set of teeth 358b project laterally away from the
central plate 356 in a second direction. The first and second sets
of teach 358a, 358b extend from opposite ends of the central plate
356, and the first and second directions are generally opposite
each other. The sets of teeth 358a, 358b are each securely held to
the central plate 356 by two outer frames 360 which extend around
the periphery of the teeth 358a, 358b.
Accordingly, and as best seen in FIG. 28, the medical device 340
includes first and second grasping jaws 344, 346 each having a
proximal end 366 and gear teeth 368 which have been bent to project
orthogonally away from a main body of the jaw 344. Accordingly, the
first set of teeth 358a receive the gear 368 of the second jaw 346,
while the second set of teeth 358b receive the gear 368 of the
first jaw 344. Notably, having the proximal ends 366 of the jaws
344, 346 bent laterally/orthogonally as shown allows a single pin
380 to be passed through the gears 368 and thus shared by both jaws
344, 346. Still further, and as shown in FIG. 29, the housing 342
may thus include only a single guide surface 382 formed by a single
slot on each lateral side of the housing 342 for receiving the ends
of the single pin 380. It can be seen that the first and second
jaws 344, 346 thereby share a single guide surface 382 (a jaw guide
surface) and guide slot, thus ensuring their coordinated operation
and smooth opening and closing.
As also shown in FIG. 29, a slot 357 is formed in the central plate
356, and is aligned with the pin 380 and jaw guide surface 382 to
receive the pin 380 as the driver 348 moves forwardly relative to
the jaws 344, 346. As discussed above and shown in FIG. 30, when
the pin 380 (shared by proximal ends 366 and gears 368 of the jaws
344, 346) has hit the distal end of the single jaw guide surface
382, the driver 348 will continue moving distally to cause the
gears 368 to rotate via the rack/teeth 358a, 358b of the driver
348, thereby inducing rotation of the jaws 344, 346.
Turning to FIGS. 31-33, another embodiment of the medical system
420 and medical device 440 are depicted. In this embodiment,
medical system 420 again includes a drive wire 422 having a distal
head 432 which is formed by bending the distal end of the drive
wire 422 into the shape shown. The medical system 420 also includes
a catheter attachment 430 which is generally a tubular member that
is connected to the distal end of the catheter 24 and is used to
slidably receive the connection block 426. The catheter attachment
430 includes a pair of openings 434 to provide access to the
control wire 422 and the connection block 426, whereby a tool may
be used to hold the connection block 426 in either a retracted or
extended position, as further described in U.S. Appl. No.
61/391,878 filed concurrently herewith, and Appl. No. 61/391,875
filed concurrently herewith, the disclosures of which are hereby
incorporated by reference in their entirety.
The medical device 440 includes a housing 442 which is detachably
connected to the catheter 24 and its catheter attachment 430 via
the connection block 426. The housing 442 slidably receives the
pair of jaws 444 which are connected to the drive wire 422 via the
driver 448. As with the previous embodiments, the driver 448
includes a socket 450 defined by locking tabs 452 which releasably
engage the distal head 432 of the drive wire 422. The distal
portion of the driver 448 includes a plurality of teeth 458 which
define a gear or rack which serves to drive rotation of the jaws
444 as previously described. The distal end 466 of the driver 448
includes a pocket defined by flanges which are used to fixedly
engage the biasing strip 490. The housing 442 further defines a
pair of guiding surfaces or slots 482 which guide the longitudinal
and rotational movement of the jaws 444.
In this embodiment, the jaws 444 and housing 442 are structured
such that in the fully retracted position (shown), the jaws 44
project (at least partially) out distally from the end of the
housing 442. As best seen in FIG. 32, as the distal head 432 is
pushed through the locking tabs 452 they are plastically deformed
outwardly to engage the shoulders 446 in the housing, and the jaws
444 are fully retracted. In this way, the length of the housing 442
can be shortened, as can the guiding slots 482 therein for guiding
the jaws 444. It can also be seen in FIG. 32 that the distal ends
of the jaws 444 include serrations 445 or other structures which
may aid in gripping tissue.
It is also noted that in this embodiment, as with all prior
embodiments, the drive wire 422 is capable of transmitting
rotational force and torque (e.g. from the proximal operating end
of the system 20/420) through the distal head 432 and the driver
448 to the jaws 444. As such the medical device 440 may be rotated
via rotation of the drive wire 422, i.e. the jaws 444, jaw pins
(e.g. 80), housing 442, and driver 448 all rotate as a unit
relative to the catheter 24. Inasmuch as the housing 442 may also
be non-rotatably connected to the connection block 426 (e.g.
depending on the friction therebetween), the connection block 426
may also rotate within the catheter attachment 430 (or the
catheter, e.g. 24) when the catheter attachment 430 is not used.
Accordingly, the orientation of the jaws 444 may be rotated through
rotation of the proximal end of the drive wire 422 to orient the
jaws relative to the tissue or material being grasped or clipped.
It has been found that forming the drive wire 422 out of a solid
nitinol wire has provided good torque transmission for rotation of
the medical device 440.
It has also been found that having the jaws 444 project at least
partially out of the housing 442 in their fully retracted position
allows the orientation of the jaws 444 to be visualized so that it
is easier to rotate the jaws 444 prior to opening and closing them
around tissue. Still further, additional tissue may be encapsulated
in the jaws 444 before the tissue abuts the distal end of the
housing 442. The distance which the jaws 444 project from the
housing 442 may be varied depending upon a particular application,
i.e. sized to correspond to the thickness of the tissue or the type
of procedure being formed to insure good spacing between the distal
ends of the jaws 444 and the distal end of the housing 442.
Turning to FIGS. 34-36, another embodiment of the medical device
540 is depicted. In this embodiment, the medical device 540 again
includes the remainder of the medical system from any of the
previous embodiments, as well as the housing 542 and pair of jaws
544 as in the previous embodiments. All prior embodiments of the
medical systems and devices, or features thereof, may be used with
this medical device 540. In this embodiment, the driver 548 again
includes a distal end 566 defining a pocket and flanges that are
used to fixably engage a biasing strip 590. The biasing strip 590
is biased radially outward, and engages the jaws 544 through most,
if not all, of their outward rotation. In this embodiment, the
biasing strip 590 is stamped to provide at least one, and
preferably a plurality of, prongs 592; four prongs 592 being shown
in the depicted embodiment. The prongs 592 are preferably formed
directly from the strip 590 by stamping, cutting or other material
processing, although the prongs 592 could be separately formed and
attached to the strip 590. The prongs preferably have a free end
which is sharp to facilitate engagement of the tissue via the
medial device 540.
In the open configuration of the medical device 540, shown in FIG.
35, the prongs 592 extend radially inwardly and are generally
orthogonal to the longitudinal axis L. A. In the closed
configuration of the medical device 540, shown in FIG. 36, the
prongs 592 project radially inwardly and proximally, preferably at
an angle of 15.degree. to 90.degree. (relative to an axis of the
respective strip portion), and more preferably about 15.degree. to
45.degree.. As best seen in FIG. 36, the prongs 592 are preferably
arranged in opposing pairs such that two prongs 592 project towards
each other to define a small lateral space therebetween.
Alternatively, the free ends of the prongs 592 may touch the free
end of the respective opposing prong 592. Still further, in another
variation shown in FIG. 36a, the strip 590a may have prongs 592a on
the opposing strip portions that are alternating (longitudinally
spaced apart in the closed configuration), and have a length such
that the free ends of the prongs 592a touch a flat portion of the
opposing strip portion in the closed configuration, and provide a
zig-zag shaped tortuous path for the tissue T. Any combination of
the above-described prong variations may be employed together.
Inasmuch as the jaws 544 have distal ends 545 forming a talon
shape, the jaws 544 define a gripping space 547 therebetween. While
the distal ends 545 of the jaws 544 directly engage each other,
tissue that is thinner than the lateral distance between the jaws
544 (i.e. a lateral width of the gripping space 547) is only
partially restrained. Accordingly, the prongs 592 extend into the
gripping space 547 to effectively reduce the lateral distance
between the jaws 544 in the area of the gripping space 547 and
directly engage the tissue positioned between the jaws 544. The
biasing strip 590 and its prongs 592 may be incorporated into any
of the prior embodiments of the medical system and device.
Turning now to FIGS. 37-39, another embodiment of the medical
device 640 is depicted. All prior embodiments of the medical
systems and devices, or features thereof, may be used with this
medical device 640. In this embodiment, the medical device again
includes a housing 642 that slidably and rotationally receives the
pair of jaws 644 which are driven through the motion by a driver
648. To facilitate engagement of the tissue between the jaws 644, a
gripping strip 695 is provided on one of the jaws 644, which may be
referred to herein as the first jaw. The gripping strip 695 is a
thin flat strip, preferably formed of a biocompatible metal or
plastic such as stainless steel or nitinol, and has a width equal
to or less than a width of the jaws 644.
The gripping strip 695 has a distal portion 697 and a proximal
portion 698. The distal portion 697 preferably includes a distal
end directly and/or fixedly attached to the distal end of the first
jaw 644, such as by a weld 696. Although a weld 696 has been shown,
the distal portion 697 of the gripping strip 695 may be attached to
the distal end 645 of the first jaw 644 the other know means such
as adhesives, various welding or soldering techniques, or other
mechanical connectors or fasteners. As previously discussed, the
jaws 644 include distal ends 645 having a curved talon shape and
preferably the weld 696 is formed at a proximal portion of the
curved distal end 645 or immediately adjacent the curved distal end
645 of the first jaw 644. In short, a distal end of the gripping
strip 695 is attached to a distal portion of the jaw 644.
The proximal portion 698 of the gripping strip 695 includes a
proximal end which is free floating, but preferably is sized and
structured to loosely engage a proximal end of the first jaw 644.
As best seen in FIGS. 37 and 38, the gripping strip 695 is bent
into a concave shape (facing the first jaws 644) such that the
distal portion 697 projects radially inwardly toward the
longitudinal axis, and preferably beyond the axis and towards the
opposing jaws 644 (in the closed configuration), while the proximal
portion 698 of the gripping strip 695 projects back radially
towards the first jaw 644 (i.e. the jaw to which it is attached).
The proximal portion 698 and proximal end of the gripping strip 695
are positioned radially outside of the driver 648 and longitudinal
axis. The proximal end of the gripping strip 695 may be attached to
the first jaw 644 if desired.
As best seen in FIG. 38, in a closed configuration of the medical
device 640, the distal portion 697 of the gripping strip 695
projects all the way across the gripping space 647 defined between
the jaws 644 and engages the opposing (or second) jaw 644. The
proximal portion 698 of the gripping strip 695 then projects back
towards the first jaw 644 as best seen in FIG. 39. In the closed
configuration of the medical device 640, when tissue T is
positioned between the jaws 644 and within the gripping space 647,
the gripping strip 695 serves to press the tissue T firmly against
the opposing jaw 644 while the distal end 645 of the jaws 644
firmly engage the tissue T therebetween. In this way, the medical
device 640 is provided with an improved grip on the tissue T.
Turning now to FIG. 40, yet another embodiment of the medical
device 740 is illustrated. All prior embodiments of the medical
systems and devices, or features thereof, may be used with this
medical device 740. This embodiment is substantially identical to
the embodiment of FIGS. 37-39, and includes a housing 742 slidably
and rotatably receiving a pair of jaws 744 which are driven by a
driver 766. A gripping strip 795 having a shape similar to the
gripping strip 695 described above, is attached at its distal end
to a distal portion of a first jaw 744 via a weld 796. In this
embodiment, the gripping strip 795 is provided with a plurality of
prongs 792, four prongs being shown in FIG. 40. A prong 792 are
similar to the prongs 592 shown and described in the embodiment of
FIGS. 34-36, and may have similar shapes and be formed similarly
thereto. Briefly, the prong 792 preferably are stamped directly
from the gripping strip 795 and have a triangular shape that has a
terminal end which is sharp to engage, preferably by slightly
piercing, the tissue between the jaws 744.
Turning now to FIGS. 41 and 42, another embodiment of the medical
850 is shown and described. In this embodiment, all the prior
embodiments of the medical system and devices, or features thereof,
may be used with the medical device 840. In particular, this
embodiment shows how a gripping strip 895 may be employed in
conjunction with a biasing strip 890. The biasing strip 890 is
substantially identical to any of the biasing strips previously
described such as strips 190, 490, and is fixedly attached to a
distal end of the driver 848. Likewise, the gripping strip 895 is
substantially identical to the gripping strips 695, 795 described
in FIGS. 37-40, and includes a distal end attached to a distal end
portion of the first jaw 844. The portion of the gripping strip 895
that overlaps with the biasing strip 890 is positioned radially
outside the biasing strip 890. Accordingly, the biasing strip 890
directly engages the gripping strip 895, which in turn is fixedly
attached to the first jaw 844 to transfer the radially outward
biasing force from the biasing strip 890 to the first jaw 844
(having the gripping strip 895). In the closed configuration of the
medical device 840, shown in FIG. 42, the gripping strip 895
preferably has a rigidity greater than the biasing strip 890 such
that it continues to extend towards and engage the opposing jaw 844
before curving laterally away from the opposing jaw, thereby
pressing both the tissue and the biasing strip 890 against the
opposing jaw 844.
While the gripping strip 895 has been shown positioned radially
outside the biasing strip 890 in the embodiment of FIGS. 41-42,
since the proximal end of the gripping strip 895 is free floating,
it can also be positioned radially inside a corresponding portion
of the biasing strip. For example, as shown in the embodiment of
the medical system 940a in FIG. 43, the medical device 940a
includes a housing 942 slidably and rotationally receiving opposing
jaws 944a. Here the gripping strip 995a is substantially identical
to the previously described gripping strips, at the proximal
portion and proximal end thereof is positioned radially inside the
biasing strip 990a as shown in FIG. 43. Preferably, the proximal
end of the gripping strip 995a is located at the juncture of the
biasing strip 990a and the driver 948a. Again here the driver 948a
includes a distal end 966a fixedly attached to the biasing strip
990a. Likewise, in this embodiment a second gripping strip 995a has
been shown attached to the opposing jaw 944a and similarly
constructed and attached to the jaw 944a as in the prior
embodiments. Accordingly, the biasing strip 990a may directly
engage and outwardly bias the jaws 944a, while the gripping strips
995a are attached to the distal ends of the jaws 944a but are sized
and structured to substantially fill the gripping space between the
jaws 944a.
A similar variation to add a second gripping strip is shown in
another embodiment of the medical device 940b and FIG. 44. As with
the embodiment of 943, the medical device 940b includes a housing
942b slidably and rotationally receiving a pair of opposing jaws
944b driven by a driver 948b. Again here the driver 948a includes a
distal end 966b fixedly attached to the biasing strip 990b. In this
embodiment, two gripping strips 995b are again provided, however
the gripping strips 995b are positioned radially outside the
biasing strip 990b. Accordingly, the biasing strip 990b presses
against the opposing gripping strips 995b, which are directly
attached to the opposing jaw 944b, to thereby bias the jaws
radially outwardly. At the same time, the gripping strips 995b
substantially fill the gripping space between the jaws 944b to
firmly engage the tissue over a greater length of the jaws 944b.
All prior embodiments of the medical systems and devices, or
features thereof, may be used with the medical devices 940a and
940b.
The foregoing description of various embodiments of the invention
has been presented for purposes of illustration and description. It
is not intended to be exhaustive or to limit the invention to the
precise embodiments disclosed. Numerous modifications or variations
are possible in light of the above teachings. The embodiments
discussed were chosen and described to provide the best
illustration of the principles of the invention and its practical
application to thereby enable one of ordinary skill in the art to
utilize the invention in various embodiments and with various
modifications as are suited to the particular use contemplated. All
such modifications and variations are within the scope of the
invention as determined by the appended claims when interpreted in
accordance with the breadth to which they are fairly, legally, and
equitably entitled.
* * * * *
References